The differential effects of sarcopenia and cachexia on overall survival for pancreatic ductal adenocarcinoma patients following pancreatectomy: A retrospective study based on a large population.
The differential effects of sarcopenia and cachexia on overall survival for pancreatic ductal adenocarcinoma patients following pancreatectomy: A retrospective study based on a large population.
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DOI：
10.1002/cam4.5779
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发表时间：
2023-05
期刊：
影响因子：
4
通讯作者：
Ke, Neng-wen
中科院分区：
文献类型：
--
作者：
Shen, Xiao-ding;Wang, Xing;Zheng, Zhen-jiang;Chen, Yong-hua;Tan, Chun-lu;Liu, Xu-bao;Ke, Neng-wen
恶病质和肌肉减少症都被认为是胰腺癌患者预后的不良预测因子;尽管肌肉减少症和恶病质有一些相似之处，但它们仍然被定义为不同的营养状况。我们的目的是探讨肌肉减少症和恶病质对胰腺导管腺癌（PDAC）患者根治性切除术后预后的不同影响。回顾性纳入了2015年1月至2022年5月期间接受PDAC手术的614例患者。肌肉减少症定义为L3总骨骼肌指数低于52.4 cm 2/m2（男性）和38.5 cm 2/m2（女性）。根据以下标准对恶病质进行分类：在过去6个月内非自愿体重减轻>5%，或体重减轻>2%且BMI <20 kg/m2，或体重减轻>2%且肌肉减少症。在纳入分析的614例患者中，分别有62%和48%被诊断为肌肉减少症和恶病质。Kaplan-Meier分析显示，肌肉减少症和/或恶病质与更差的总生存期（OS）而不是更差的无复发生存期（RFS）显著相关。此外，考克斯回归分析显示，恶病质而不是肌肉减少症是所有PDAC患者OS的不利因素。对于低分化PDAC，恶病质和肌肉减少症均与OS缩短显著相关。然而，对于中/高分化PADC，恶病质是不良OS的独立因素，而不是肌肉减少症。肌减少和恶病质对PDAC根治术患者OS的影响不同。这种差异可能为术前处理提供一些重要信息。通过对614例PDAC患者的临床资料分析，发现肌减少症和恶病质对PDAC根治术患者的OS有不同的影响。
Both cachexia and sarcopenia have been considered adverse predictors for prognosis in patients with pancreatic cancer; although sarcopenia and cachexia share some similarities, they are still defined as distinct nutritional conditions. We aimed to explore the differential impacts of sarcopenia and cachexia on prognosis for pancreatic ductal adenocarcinoma (PDAC) patients following radical excision. From January 2015 to May 2022, 614 patients undergoing surgery for PDAC were retrospectively included. Sarcopenia was defined as the L3 total skeletal muscle index below 52.4 cm2/m2 (men) and 38.5 cm2/m2 (women). Cachexia was classified according to the following criteria: involuntary weight loss >5% over the past 6 months, or weight loss >2% and BMI <20 kg/m2, or weight loss >2% and sarcopenia. Of the 614 patients included in the analysis, 62% and 48% were diagnosed with sarcopenia and cachexia, respectively. Kaplan–Meier analysis showed that sarcopenia and/or cachexia were significantly associated with worse overall survival (OS) rather than worse recurrence‐free survival (RFS). Moreover, Cox regression analysis revealed that cachexia rather than sarcopenia was an adverse factor for OS in all PDAC patients. For poorly differentiated PDAC, both cachexia and sarcopenia were significantly associated with shorter OS. However, for moderately/well‐differentiated PADC, cachexia was an independent factor for adverse OS, but not sarcopenia. Sarcopenia and cachexia have different effects on OS for PDAC patients undergoing radical excision. This difference may provide some important information for preoperative management. We found that sarcopenia and cachexia have different effects on OS for PDAC patients undergoing radical excision by studying the data of 614 PDAC patients.
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影响因子：
5.2
作者：
Martin D;Maeder Y;Kobayashi K;Schneider M;Koerfer J;Melloul E;Halkic N;Hübner M;Demartines N;Becce F;Uldry E
通讯作者：
Uldry E
影响因子：
6.3
作者：
Arends, Jann;Bachmann, Patrick;Preiser, Jean-Charles
通讯作者：
Preiser, Jean-Charles
影响因子：
3.4
作者：
Jensen, Gordon L.
通讯作者：
Jensen, Gordon L.
影响因子：
81.5
作者：
Baracos, Vickie E.;Martin, Lisa;Fearon, Kenneth C. H.
通讯作者：
Fearon, Kenneth C. H.
DOI：
10.1097/mco.0b013e328333c1c1
发表时间：
2010-01-01
影响因子：
3.1
作者：
Cruz-Jentoft, Alfonso J.;Landi, Francesco;Michel, Jean-Pierre
通讯作者：
Michel, Jean-Pierre